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Individual

MR. WILLIAM HENRY MUKES JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
2500 S BROADWAY STE 100, SUITE 100, EDMOND, OK 73013-4039
(316) 990-1907
(405) 241-5221
Mailing address
2500 S. BROADWAY ST BLDG 100, SUITE 100, EDMOND, OK 73013-4038
(316) 990-1907
(405) 241-5221

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1041
OK
106H00000X
Marriage & Family Therapist
1158
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200378070A
OK
Enumeration date
01/05/2010
Last updated
10/18/2012
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